Life Sustaining Statute, Mississippi

Life Sustaining Statute, Mississippi

A life sustaining statute is generally legal in most states and will generally be enforce and made in the presence of witnesses and a notary public. There is a general format when it come to life sustaining statutes but the details may differ depending on the state you are in. DNR or Do Not Resuscitate protocols do not exist in the state of Mississippi.

A Life Sustaining Statute or a uniform living will is a legal document written by someone who is diagnosed with an illness that may be difficult to cure or has a chance to become a terminal illness. A life sustaining statute or uniform living will states the wishes of the person who is ill. It states what they would want to happen in the case that their illness does become terminal or that they pass the point of no return. This document states the types of medications he will be restricted to and from. It also states that if the person decided to prolong or shorten his or her life, that he or she did it willingly, of sound mind, has been informed of possible treatments and procedures, and understands all legal implications of his or her decisions. The document is generally written (this may vary among states) with the writer’s signature, City of residence, County of residence, State of residence, Social Security Number, the Date it was signed, and the names of the witnesses present during this event. It is then presented to a notary public for notarization and publishing. Finally, you are encouraged to keep multiple copies. Make sure that theses can be accessible with your doctor, lawyer, and family members.

Declaration of Intention Provided by Mississippi Withdrawal of Life Saving Mechanisms Act, Mississippi Code 41-41-107

DECLARATION made on ___________ by ___________________ of ____________, _______________.

I, ________________, being of sound mind, declare that if at any time I should suffer a terminal physical condition which causes me severe distress or unconsciousness, and my physician, with the concurrence of two (2) other physicians, believes that there is no expectation of my regaining consciousness or a state of health that is meaningful to me and but for the use of life-sustaining mechanisms my death would be imminent, I desire that the mechanisms be withdrawn so that I may die naturally. However, if I have been diagnosed as pregnant and that diagnosis is known to my physician, this declaration shall have no force or effect during the course of my pregnancy. I further declare that this declaration shall be honored by my family and my physician as the final expression of my desires concerning the manner in which I die.

SIGNED:

________________________________________________________________
Social Security number: ___________

I hereby witness this declaration and attest that:
(1) I personally know the Declarant and believe the Declarant to be of sound mind.
(2) To the best of my knowledge, at the time of the execution of this declaration, I:
(a) Am not related to the Declarant by blood or marriage,
(b) Do not have any claim on the estate of the Declarant,
(c) Am not entitled to any portion of the Declarant’s estate by any will or operation of law, and
(d) Am not a physician attending the Declarant or a person employed by a physician attending the Declarant.
WITNESS:

________________________________________________________________

Address:
WITNESS:

________________________________________________________________

Address:
Declaration of Intention Provided by Mississippi Withdrawal of Life Saving Mechanisms Act, Mississippi Code 41-41-107
Review List

This review list is provided to inform you about this document in question and assist you in its preparation. This simple Life Sustaining Declaration is valid in Mississippi. Check with a local hospital or doctor’s office, as well as with an experienced medical attorney, to assure yourself of its compliance with current statute (s) in your state.

1. Make multiple copies. Give one to your doctor (s), the local hospital, and have others available through your attorney and family. Remember, these kinds of documents are needed in emergency situations at worst and under stressful circumstances at best. So be sure they are available to the appropriate people easily, when needed.

Free Printable Life Sustaining Statute, Mississippi FormFree Printable Life Sustaining Statute, Mississippi Form

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